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FINAL EXAM - NR507 / NR 507 Advanced Pathophysiology
Newest Questions and Verified Answers- Chamberlain
1. Which of the following is true regarding a complicated urinary tract infec-
tion
Ans>> Can be caused by a structural urinary tract disorder
2. Which of the following is a risk factor for the development of a urinary tract infection
(UTI)
Ans>> Pregnancy
3. A symptom of a lower urinary tract infection includes
Ans>> urgency
4. Women are at a higher risk for the development of a UTI because of having a
shorter urethra
Ans>> true
5. Which of the following can help to prevent a UTI
Ans>> Increase water consump- tion
,6. Uncomplicated UTI : Occurs in the normal urinary tract
Responds well to short course of antibiotic therapy
Simple cystitis in non-pregnant women without any urologic abnormalities
7. Complicated UTI : UTI extends beyond the bladder
Caused by structural or functional urinary tract abnormalities or untreated UTI Infants and
older adults affected
Associated with : indwelling catheters, renal calculi, diabetes, pregnancy
8. A 25 year- old female presents to the primary care office with urinary burning and
frequency for the last 3 days. She denies any fever, chills, back pain. Her gynecological
history is negative and reports no vaginal discharge. The only new information
reported is that she recently had sexual intercourse with a new male partner.
The NP obtains a urinalysis and determines that the urine contains leukocytes, RBCs,
nitrites, and WBCs. No casts are identified. Based on symptom presen- tation and UA
results, the patient can be diagnosed with
Ans>> cystitis
9. J.S. is an 80 -year-old patient who resides in a local nursing home. He recently
became confused and then fell while ambulating to the bathroom three days ago.
Because of his confusion and fall, he was transferred to the acute care facility for
evaluation and treatment. Lab work revealed that the patient was very dehydrated with
,hypernatremia identified and appropriate intravenous fluids started. Cystitis was also
identified from the urinalysis. He was also noted to have red and excoriated skin
between the buttocks and inner thighs due to urinary frequency and dribbling. To help
with skin healing and to prevent further urine leakage, an indwelling catheter was
inserted. Two days after the catheter was placed, the patient spiked a fever of 102
degrees Fahrenheit associated with shaking chills. An intense, foul odor was noted in
the urine. On examination of the flank area, the patient yelled out when touched. A
urine culture was obtained and came back positive for nitrites and RBCs. Urine
microscopy revealed >100,000 WBC/hpf and casts.
,Based on the information provided in the case, the patient can most likely be
diagnosed with
Ans>> pyelonephritis
10. Identify the major risk factor J.S. has that is associated with pyelonephri- tis
Ans>> indwelling foley catheter
11. The urinalysis of a patient with a complicated UTI will show WBCs and casts
: true
12. Upon examination of a urinalysis, the NP can highly suspect that the
causative bacteria are gram negative because of the presence of
Ans>> nitrites
13. A 21-year-old patient reports to the primary care clinic complaining of urinary
urgency, frequency and burning. She also reports a small amount of vaginal discharge
that contains an odor. It is likely that the NP will perform a vaginal exam at this visit
Ans>> true
14. The NP would know that the patient most likely has an uncomplicated UTI
because
Ans>> The UTI responds well to a short course of antibiotic therapy.
15. A common organism that causes a urinary tract infection include
Ans>> Staphy- lococcus saprophyticus.
,E coli
16. The purpose of straining in BPH is to overcome the obstruction encoun- tered
during urination
Ans>> true
17. The peripheral zone of the prostate is the largest zone
Ans>> true
18. On a digital rectal exam to assess the quality of the prostate, the NP would be
concerned with which of the following findings
Ans>> hard nodule
19. There is a significant risk for men with benign prostatic hyperplasia (BPH) to
develop cellular mutations that lead to prostate cancer
Ans>> false
20. The patient most often develops symptoms of BPH when
Ans>> The prostatic urethra becomes obstructed.
21. Irritative symptoms : urinary frequency
nocturia
urgency that results from bladder hypertrophy and dysfunction
22. obstructive symptoms : incomplete emptying
post-void dribbling
,23. The action of a 5-Alpha-reductase inhibitor causes
Ans>> Shrinkage of the prostate gland.
24. Men who have BPH are prone to developing a UTI because
Ans>> Stagnated urine in the bladder promotes bacterial growth.
25. The prostate specific antigen (PSA) helps to liquefy semen post-ejacula- tion
Ans>> true
,26. The underlying cause of BPH is that normal prostate cells respond to
increases in dihydrotestosterone that causes them to live longer and multi- ply
Ans>> true
27. The location of the characteristic hyperplastic nodules of BPH is
Ans>> In the periurethral zone.
28. The type of stone that forms due to a urinary tract infection is
Ans>> Struvite stone.
29. Renal stones are formed when calcium and oxalate in the urine combine.-
: true
30. Renal calculi are typically confined to the bladder
Ans>> false
31. The most common type of stone is
Ans>> calcium stone
32. The gold standard for diagnosing a renal stone is a urinalysis
Ans>> false (ct scan)
33. A 45-year-old male presents to the primary care office with right flank pain that he
describes as unremitting; he also reports nausea and vomiting. The NP performs an
exam and observes him writhing in pain on the exam table with the inability to find a
comfortable position. He is afebrile, BP 156/88 mmHg and HR 106/min. Right flank
, is mildly tender on palpation. Abdominal exam is negative for any abnormality. A
urinalysis was performed and revealed 1+ blood. Urine microscopy also revealed 10-20
RBCs per high-power field (hpf). A kidney stone is suspected. The patient reports no
prior history of
a kidney stone. After providing the patient an analgesic, where the patient reported
mild relief, the NP had the patient transferred to the emergency room for intravenous
fluids, pain management and further work-up for the kidney stone. Upon follow-up in
the office a week later, the patient reported that he was diagnosed with a kidney stone,
but he was not aware of the type of stone or the cause for it. He was very concerned
about why he had the associated severe flank pain and asked the NP why the pain was
so severe and how could he avoid another stone in the future.
Since this is the patient's first episode of having a kidney stone, it is most likely a calcium
stone. It is the most common stone with the cause unknown. If there was an opportunity
for the patient to pass the stone, it could be analyzed to determine the type.
The NP discusses the cause of the pain and tells the patient that stones travel down the
ureter to produce renal colic. The pain intensifies if the stone lodges in the ureter that
creates almost unbearable pain. The NP also addresses prevention measures with the
patient. Identify below which measures the NP should recommend
Ans>> adequate hydration
balanced diet
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